目的 总结2例股骨远端内侧闭合截骨术中并发外侧合页骨折的诊治经验。方法 2022年6月及9月共收治2例膝关节外侧单间室关节炎伴外翻畸形女性患者。患者年龄为54、47岁，患膝关节活动度分别为0°～110°、0°～120°，美国特种外科医院（HSS）评分分别为78、72分，疼痛视觉模拟评分（VAS）均为2分。股骨远端内侧闭合截骨术中发生外侧合页骨折，予以锁定加压远端股骨接骨板固定。结果 术后切口Ⅰ期愈合。2例患者分别获随访2、3个月，患者膝关节疼痛明显减轻，VAS评分均为0分；外翻畸形矫正，膝关节活动度分别为0°～120°、0°～130°，HSS评分分别为82、85分；影像学检查示截骨端愈合良好，未出现关节炎进展，力线位置满意。结论 股骨远端内侧闭合截骨术中并发外侧合页骨折均为不稳定性骨折，可选择外侧接骨板固定以降低对矫正手术效果的影响。
Citation：
张志广, 邱越, 环大维, 张超, 夏天卫, 沈计荣. 股骨远端内侧闭合截骨术中并发外侧合页骨折两例. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(4): 507-508. doi: 10.7507/1002-1892.202212046
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Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
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- 1. Kim TW, Lee MC, Cho JH, et al. The ideal location of the lateral hinge in medial closing wedge osteotomy of the distal femur: analysis of soft tissue coverage and bone density. Am J Sports Med, 2019, 47(12): 2945-2951.
- 2. Nha KW, Chang YS, Shon OJ, et al. Where is the target point to prevent cortical hinge fracture in medial closing-wedge distal femoral varus osteotomy? J Knee Surg, 2019, 32(3): 274-279.
- 3. Kim SC, Kim JS, Yoo HJ, et al. Factors affecting the disparity between preoperative planning and postoperative correction status in distal femoral osteotomy. Knee, 2020, 27(5): 1608-1617.
- 4. Nakayama H, Kanto R, Iseki T, et al. How the orientation of osteotomy in biplanar lateral closed-wedge distal femoral osteotomy influences the rotational alignment of the knee in all dimensional planes. Knee, 2021, 29: 167-173.
- 5. Matsushita T, Akiyama T, Osano K, et al. Biomechanical analysis of the role of hinge support fixators on hinge stability in medial closing wedge distal femoral osteotomy. Clin Biomech (Bristol, Avon), 2022, 91: 105528. doi: 10.1016/j.clinbiomech.2021.105528.
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